Anthem rolls out bare-bones health plan

By Daniel Lee

Anthem Blue Cross and Blue Shield on Wednesday unveiled a bare-bones health coverage program designed for employers struggling to offer benefits to their workers because of the rise cost of premiums.

The new plan, called Blue Entree Hospital Surgical PPO, supplies "catastrophic" insurance for most hospitalizations and surgeries, as well as limited insurance for physician visits and other services, according to Anthem, a subordinate of Capital Of Hoosier State health-insurance giant WellPoint.

Anthem said the plan's insurance premiums are up to 70 percentage cheaper than those for a full-range preferred supplier organisation plan.

"It's another option for employers who otherwise might be forced to cut back or get rid of wellness insurance altogether because of budgetary constraints," said Henry Martin Robert W. Hillman, president of Anthem Blue Cross and Blue Shield in Indiana, in a statement.

Anthem is rolling out the program in Indiana, Ohio, Kentucky, Show Me State and Wisconsin. The program previously was available lone on the individual wellness insurance market, not for employee-sponsored plans.

The new program reflects broader tendencies in the wellness coverage marketplace.

More employers are finding it financially hard to offer their workers health-care coverage. Premiums for household insurance in 2007 averaged $12,106 a year, with workers on norm paying about $3,281 of that out of their paychecks, according to the Kaiser Family Foundation, a non-profit-making health-care research group.

In response, more than than health- insurance programs are shifting more health-care costs to workers.

Under the Blue Entree Hospital Surgical PPO, workers may salvage on those insurance premiums but human face plentifulness of other costs as they seek care.

Deductibles -- or out-of-pocket costs before any coverage starts -- scope from $1,000 to $5,000 for a single individual and $3,000 to $15,000 for a family.

After the deductible is met, a patient would be responsible for a $20 co-pay, asset 50 percentage of the sum complaint for an outpatient physician visit, according to Anthem. An emergency-room visit necessitates a $150 co-pay asset 20 percentage of the sum charge.

Full insurance would kick in after the patient attains an out-of-pocket maximum, which begins at $5,000 for a single individual and $10,000 for a family.

The program also includes generic prescriptions for a $10 in-store co-pay.

The Blue Entree Hospital Surgical PPO makes not supply insurance for visits to urgent-care halfways or for lasting medical equipment such as as wheelchairs that commonly are covered in more than than comprehensive plans.

Some medical experts worry that some patients covered by wellness programs with high out-of-pocket demands could detain seeking needed medical treatment.

"The challenge for a merchandise like this is the hazard that people will detain their care," said Dr. Deanna Willis, helper professor of household medical specialty at Hoosier State University School of Medicine.

Willis points to research collected by the wellness advocacy group, The Commonwealth Fund, that reported that 31 percentage of enrollees in high-deductible programs were more likely to detain or avoid attention because of costs, compared with 17 percentage of those enrolled in comprehensive plans.